Drinking too much alcohol: health risks, units and getting help

The NHS explains that units are a simple way of expressing the quantity of pure alcohol in a drink. One unit equals 10 ml or 8 g of pure alcohol, which is around the amount the average adult can process in an hour, although this varies from person to person. The number of units depends on both the size of the drink and its strength.

You can work out the units in any drink by multiplying its strength (ABV, shown as a percentage on the label) by its volume in millilitres and dividing by 1,000. By way of example from the NHS guide, a pint of strong lager at 5.2% contains about 3 units, a standard 175 ml glass of 12% wine about 2.1 units, a large 250 ml glass 3 units and a single small shot of spirits 1 unit. A 750 ml bottle of 13.5% wine contains 10 units.

Larger measures are easy to underestimate when pouring at home, so measuring for a week can be revealing.

To keep health risks low if you drink most weeks, the NHS says men and women are advised not to drink more than 14 units a week on a regular basis. If you regularly drink as much as 14 units, spread it over 3 or more days, and try to have several drink-free days each week.

The NHS also says the idea that moderate drinking is good for the heart has been revised: the evidence on a protective effect is now thought to be less strong than previously believed. If you are pregnant or think you could become pregnant, the safest approach is not to drink alcohol at all.

The NHS lists the risks of drinking more than 14 units a week over many years as mouth cancer, throat cancer and breast cancer, stroke, heart disease, liver disease, and brain damage that may cause memory loss and changes in behaviour. It notes that there is now a better understanding of the link between drinking and a range of cancers.

The risk is graded. The NHS says the effects depend on how much you drink and that the less you drink, the lower the health risks. It also describes the link with mental health: high-risk drinking can make mental health worse, and research has found strong links with self-harm and suicide.

Alcohol also interacts with other risk factors covered in this library. HEART UK, for instance, notes that alcohol can significantly raise triglyceride levels in some people, and the NHS lists alcohol as a contributor to high cholesterol and to the risk of osteoporosis, bowel cancer, stomach cancer and breast cancer.

Binge drinking means drinking too much alcohol too quickly on a single occasion. The NHS defines it as more than 8 units in a single session for men, or more than 6 units for women. It increases the risk of accidents resulting in injury, sometimes causing death, misjudging risky situations and losing self-control, for example having unprotected sex or becoming involved in violence.

To reduce risk on a single occasion, the NHS suggests limiting how much you drink, drinking more slowly, drinking with food and alternating alcoholic drinks with water or non-alcoholic drinks.

The NHS says you may need help if you often feel the need to have a drink, other people warn you about how much you are drinking, or you think your drinking is causing you problems. A good place to start is a GP, and it helps to be accurate and honest about how much you drink and any problems it causes.

If you have become physically dependent, stopping overnight could be harmful, so seek advice about it and about any medicine you might need to do it safely. Mild or moderate withdrawal symptoms that suggest you may need medicine include anxiety after waking, sweating and mild tremors, nausea or retching in the morning, and vomiting. Call 999 if you have severe symptoms such as hallucinations, severe tremors, seizures or fits.

Most people receive support to stop drinking and recovery support in the community, according to the NHS. Medicine to help you stop can often be taken at home or when attending a local service daily, though some people need a short stay in a medically supported unit. Intensive rehabilitation is usually for people with medium or high levels of dependence or for whom other help has not worked. Mutual aid groups such as Alcoholics Anonymous and SMART Recovery are available in most areas.

Local authorities are responsible for alcohol treatment services. The NHS notes that residential rehabilitation may require an additional assessment for funding, and that it is also possible to pay for residential rehabilitation privately, with some medical insurers funding it for a limited period.